Non-Surgical Treatment of Thyroid Nodules

Thyroid Ablation

Thyroid ablation originated in Korea in 2007 and is currently performed in various countries around the world. Türkiye is among the pioneering nations in this field and boasts highly trained physicians. Training sessions are organized almost every month for physicians from abroad—including countries such as Italy, Spain, Thailand, Egypt, and Israel—to learn about thyroid ablation and benefit from the expertise of Turkish doctors.

  • The prevalence of thyroid nodules in the general population ranges from 30% to 40%.
  • Approximately 5% of this group has a malignant thyroid nodule.

The Thyroid Gland Can Be Preserved in Patients with Thyroid Nodules Through Ablation Therapy

What Do the Guidelines Say?

European Thyroid Association (ETA) 2020 Guideline
Imaging-guided ablation according to the ETA guidelines:

  • in symptomatic benign nodules
  • in nodules that cause cosmetic problems
  • in patients who do not wish to undergo surgery

It is one of the recommended treatment options.
Link to our publication detailing our personal clinical experience:
Eryuruk, U., Bekci̇, T., Tonkaz, M., Tasdemir, M. N., Gunay, Y. E., & Dikbas, O. (2025). Clinical Outcomes and Volume Reduction Predictors Following Microwave Ablation of Benign Thyroid Nodules: A Comparative Study of Solitary Nodules and Multinodular Goitres. Academic Radiology.

For further information

To find out more about thyroid nodules and current treatment approaches, or to discuss the assessment process and suitable treatment options, please contact our team of specialists.

The information provided here is not intended for diagnostic, therapeutic or treatment purposes; it has been compiled for information purposes only.

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For many patients diagnosed with a thyroid nodule, the greatest fear is having their thyroid gland completely removed and being forced to take medication for the rest of their lives. However, thanks to advances in interventional radiology techniques, it is now possible to treat many patients whilst preserving their thyroid gland. The method at the heart of this approach is thyroid ablation.

Why Is It Important to Protect the Thyroid?

The thyroid gland is not merely an organ; it is the body’s metabolic centre. Post-surgery:

  • permanent hormone deficiency,
  • Lifelong use of levothyroxine,
  • problems with hormone dose adjustment,
  • Risks associated with the vocal cord and parathyroid glands

situations such as these may arise.

For this reason, the fundamental philosophy of modern thyroid treatment is now as follows:
“Preserve the organ where possible; target the disease.”
Ablation therapy is based entirely on this principle.

What Is Thyroid Ablation?

Thyroid ablation is the controlled destruction of diseased tissue using heat, via a fine needle inserted into the nodule under ultrasound guidance.
The main methods used are:

  • Radiofrequency Ablation (RFA)
  • Microwave Ablation (MWA)
    During the procedure:
  • No incision is made
  • General anaesthesia is not required
  • The thyroid gland is not removed
  • Only the nodule is treated

For this reason, ablation is regarded as a minimally invasive, organ-preserving treatment.

The Advantages of Ablation over Surgery

Scientific studies show that ablation offers advantages over surgery in many respects.

Organ-Preserving Treatment

During surgery, the thyroid lobe or the entire thyroid gland is usually removed.

During ablation:

✔ The thyroid remains in place

✔ Natural hormone production is maintained

Long-Term Effect (Meta-Analysis Data)

Meta-analyses show that:
RFA and MWA significantly reduce nodule volume

  • A permanent reduction of 57–77 per cent is achieved over a 5-year follow-up period
  • the regrowth rate is only 5–9 per cent

Patient Comfort

Thermal ablation techniques:

  • can be applied to the foot,
  • does not require general anaesthesia,
  • promotes rapid recovery,
  • the cosmetic results are better.

Most patients:

👉 He goes home on the day of the transaction

👉 The next day, life returns to normal.

Lower Risk of Complications

The overall reported complication rate for ablation is only around 2–3 per cent, and the rate of permanent serious complications is less than 1 per cent.

Compared to surgery:

  • There is virtually no persistent hoarseness.
  • The risk of hypocalcaemia is virtually non-existent.
  • The risk of infection is very low.

How is an Ablation Procedure Performed?

  • 1. Patient Selection

    Prior to this: an ultrasound scan, biopsy results, hormone tests and determination of the nodule type are carried out.

  • 2. Trading Day

    The patient arrives on an empty stomach. The neck area is numbed with a local anaesthetic. An ablation needle is inserted under ultrasound guidance. The nodule is cauterised in a controlled manner. Procedure duration: 10–30 minutes

  • 3. Technical Principle (Moving-shot Technique)

    In modern ablation, nodules are treated by dividing the area into small sections and applying controlled energy, thereby protecting the surrounding tissues. Thanks to this technique: ✔ the risk of nerve damage is reduced ✔ the trachea and blood vessels are protected.

  • 4. Post-Procedure

    Brief application of ice to the neck Mild painkillers Discharge on the same day Follow-up: Ultrasound scans at 1, 6 and 12 months.

For Which Patients Is Ablation Ideal?

✅ Benign nodules

✅ Nodules causing compression symptoms

✅ Cosmetic swelling

✅ Autonomous nodules

✅ Patients who do not wish to undergo surgery

✅ People at high risk from surgery

Ablation in Cancer: A New Era

New meta-analyses suggest that ablation in selected cases of low-risk papillary thyroid cancer:

  • Volume loss of up to 99 per cent
  • low progression rate
  • low complication rate

shows that it provides .
For this reason, ablation is now being considered as an alternative to surgery for selected cases of microcarcinoma in some centres.

A New Paradigm in Modern Thyroid Treatment

Previous approach:
➡ Surgery if a nodule is present
Current approach:
➡ Organ-preserving, minimal treatment in suitable patients
Ablation, alongside advances in interventional radiology:

  • safer,
  • more comfortable,
  • supported by strong scientific evidence

It has become a form of treatment.

In conclusion;
A thyroid nodule no longer necessarily means surgery for most patients. Current guidelines and meta-analyses show that:
Thyroid ablation is a modern treatment that is both effective and safe, whilst preserving the thyroid, in suitable patients.

Watch our Thyroid Ablation Information Video

This post has been prepared in accordance with the Regulation on Promotion and Information Activities in Health Services, published in the Official Gazette on 12 November 2025. The information contained in this post is for general information purposes only and does not constitute medical advice or a recommendation for treatment. The outcomes of all medical procedures, including surgical and interventional procedures, may vary from person to person. Please consult your doctor for diagnosis and treatment.

Frequently Asked Questions

Everything You Need to Know About Thyroid Ablation

We have compiled the most frequently asked questions about thyroid nodules, non-surgical treatment methods and ablation procedures. The information provided here is for guidance only; the most accurate assessment should be made following a consultation with a specialist doctor.
How is a thyroid ablation procedure performed?

The thyroid ablation procedure involves the insertion of a special needle into the nodule under ultrasound guidance, followed by its ablation.

Can ablation be performed on parathyroid adenomas as well?

Yes. Parathyroid adenomas disrupt calcium metabolism and cause osteoporosis. Since it is not possible to remove them individually through surgery, the entire thyroid gland is removed, and the patient is left dependent on medication for life. However, with ablation, parathyroid adenomas are destroyed in a 10-minute procedure without the need for thyroid removal, and the patient’s calcium levels return to normal after a certain period of time.

Is it necessary to be admitted to the hospital before the procedure?

No. The patient is admitted on the same day and is discharged immediately after the procedure, still on the same day.

Will I feel any pain during or after the procedure?

To ensure patients do not feel pain, the area is numbed with a local anesthetic before the procedure, and patients remain conscious during the procedure. If necessary, sedatives can be administered through the intravenous line established before the procedure. Significant pain is not expected after the procedure, and patients are advised to take oral pain relievers if needed.

Will there be any marks left at the site of the procedure?

Since the procedure is performed with a needle, the area is covered immediately afterward with just a small band-aid, and no scar remains after the procedure.

How long after the procedure does recovery begin?

The purpose of the procedure is to destroy unwanted tissue by burning it. Over time, the body’s immune system eliminates the destroyed tissue. After one year, the targeted reduction rate is 80%–90%.

How long does the process take?

It varies from patient to patient and lasts between 10 and 30 minutes.

If I choose the ablation method, could I still need surgery in the future for another reason?

Yes. The ablation procedure does not preclude any surgery.

Could I experience hoarseness or bleeding?

While every procedure carries its own risks, the ablation procedure also involves some risks, albeit very minor ones. However, to date, hoarseness has occurred in only 1% of patients who have undergone the ablation procedure, and it resolved within 3 months.

Can I go to work the day after the procedure?

Patients are usually able to return to their normal lives the next day, though in rare cases, one day of rest is required.

Is this a one-time process?

The procedure is usually performed only once, but in rare cases, it may be necessary to repeat it at a later time if deemed necessary.

If you have any further questions on this matter, please get in touch with us by filling in the relevant fields in the contact section; we will be happy to provide you with an answer as soon as possible.
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